COMPARATIVE STUDY ON THE EFFECTIVENESS OF NOKAMEN FOR PREVENTING EXACERBATIONS OF CHRONIC RECURRENT CYSTITIS IN WOMEN
Litvinec E.A., Litvinec V.E.
DVNZ "Ivano-Frankivsk National Medical University"
The purpose of the study: to study the efficacy and safety of using Nokamen phytocomplex for preventing exacerbations of chronic recurrent cystitis.
Materials and methods. We have carried out an open monocentric, comparative study which involved 60 women aged 20-65 years with chronic recurrent cystitis. In order to prevent the exacerbation of chronic recurrent cystitis based on a random sample, the patients were divided into II groups. Nokamen phytocomplex at a dose of 1 tablet 2 times a day for 3 months was intended to the main group (30 patients). The second group (30 patients) - the comparison group took an tincture of phytomixture "Kidney" at a dose of 50 ml 3 times a day for 3 months also.
Results. Analysis of the results has shown that the use of Nokamen phytocomplex within 3 months after the treatment of the last episode of exacerbation of chronic cystitis significantly reduces the incidence of relapses in comparison with phytomixture. Thus, in the main group of patients receiving Nokamen, an exacerbation of chronic cystitis was reported in 6 months - in 3 (10.0%) patients, while in the comparison group – in 18 (60.0%) patients.
Conclusion. This study has shown that the use of a balanced phytocomplex of Nokamen for 3 months compared with phytomixture is more effective in preventing exacerbations of chronic recurrent cystitis. So, it can be recommended for wide use as a highly effective and safe remedy.
Key words: chronic recurrent cystitis, Nokamen, phytomixture.
Cystitis is an infectious and inflammatory process in the wall of the bladder, which is localized predominantly in the mucous membrane [2, 5, 6]. The prevalence of acute cystitis in Ukraine is 314 per 100 thousand people, and chronic cystitis - 135 per 100 thousand people. Most patients are young women and women in the pre-menopausal period. If the infection of the bladder is constantly repeated (periodic relapse of its inflammation), the chronic cystitis, which has the ICD-10 code - N30.1-N30.2 can be diagnosed. Chronic recurrent cystitis or chronic cystitis with frequent exacerbations is the most common pathology diagnosed in women of reproductive age [1, 3, 5].
Based on the statistics, every third to fourth woman in the most active reproductive and working age (20-40 years old) experiences acute cystitis, and in one third it becomes recurrent. More often, recurrence occurs within the first three months after the first episode [2, 5]. Another study, which covered a wider age range of women (17-82 years), has shown even more global problem. Recurrent cystitis occurs in 45% of patients during the first year. Among the women 55 years of age and older, each second suffers from repeated exacerbations [10].
Women are highly susceptible to relapse of cystitis, which can be explained by such factors as: anatomical and physiological features of the female body (short and wide urethra, proximity to the reservoirs of opportunistic bacteria);
gynecological diseases associated with inflammation and hormonal components that disturb vaginal dysbiosis; frequency of sexual acts, and contraception peculiarities. A significant factor of the bladder infection is a sexual intercourse.
The variability of the location of the urethra outer opening creates a high probability of vaginal ectopia, while the urethra opens directly into the vestibule of the vagina. This results conditions for the retrograde passage of the vaginal contents into the bladder during sexual intercourse. In addition, the common "complication" of the onset of sexual activity is the formation of gimenouurethral conjunctions, resulting urethra hypermobility, which is displaced in the vagina during coitus. Non-observance of sexual hygiene causes a cystitis attack almost after every sexual intercourse [2, 3, 5].
Adhesion (sticking) of certain types of bacteria to the epithelium of the bladder plays the important role in the development of cystitis. Spicy food and prolonged retention of urination, which can lead to persistent functional disorders, in which the consistency between the bladder muscles are lost, also contributes to chronic cystitis [5, 6, 7]